Active NPI
Montana Gastroenterology, PLLC
- Clinic/Center
- Missoula, MT
National Provider Identifier
1821612946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- MONTANA GASTROENTEROLOGY, PLLC
- Practice address
- 1930 W Broadway
Ste a
Missoula, MT 59808 - Phone
- (406) 541-6844
- Fax
- (406) 541-6843
- NPI assigned
- Jun 4, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert McCarville
- Title
- Authorized Official
- Phone
- (417) 889-2040
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
1930 W Broadway
Ste a
Missoula, MT 59808
Mailing address
2808 S Ingram Mill Rd BLDG B
Springfield, MO 65804-4017
Phone (417) 889-2040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 27D2267430 | Montana Gastroenterology, PLLC | Compliance | Feb 8, 2027 |
National Provider Directory
National Provider DirectoryLocations
500 W Broadway St
Ste A
Missoula, MT 59802
Phone (406) 284-5560
1930 W Broadway St
Ste A
Missoula, MT 59808
Phone (406) 541-6844
500 W Broadway St
Bldg 4
Missoula, MT 59802
Practitioners & affiliated clinicians
Practitioners 35
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591228800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1628467200000",
"number": "1821612946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2808 S INGRAM MILL RD BLDG B",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658044017",
"telephone_number": "417-889-2040",
"fax_number": "417-719-7896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1930 W BROADWAY",
"address_2": "STE A",
"city": "MISSOULA",
"state": "MT",
"postal_code": "59808",
"telephone_number": "406-541-6844",
"fax_number": "406-541-6843"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MONTANA GASTROENTEROLOGY, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-06-04",
"last_updated": "2021-08-09",
"certification_date": "2021-07-15",
"status": "A",
"authorized_official_last_name": "MCCARVILLE",
"authorized_official_first_name": "ROBERT",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "417-889-2040"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.